Los Angeles County and the State of California stand to be hit the hardest with the potential repeal of the Affordable Care Act. The picture is just as devastating for counties nationwide, which was a major topic of discussion at this year’s National Association of Counties Conference and Exposition.

County Supervisors Mark Ridley-Thomas and Kathryn Barger traveled to Columbus, Ohio for NACo’s annual non-partisan meeting with over 2,000 county delegates from nearly every state in the nation. The annual conference is the only meeting that draws a cross section of elected officials and county staff from across the country. Attendees from rural and urban counties, with large and small staff and budgets – all come together for four days of education, networking and sessions aimed to help improve residents’ lives and the efficiency of county government.

This year, amidst federal uncertainty about the future of the Affordable Care Act, health care was a focus of concern at NACo’s Annual Meeting.

“Health care is not to be treated as a partisan issue,” said Los Angeles County Board of Supervisors Chairman Mark Ridley-Thomas. “We operate in a non-partisan environment and therefore aim to serve our constituents irrespective of their political orientation.”

According to the National Association of Counties, it is the duty of local government to fulfill public health and safety services for some of the most vulnerable residents including children, older adults, and people with disabilities. NACo asserted that the health care debate should be about improving health outcomes and not simply a budget exercise. NACo further asserted that Congress is orchestrating a massive cost shift beyond the capacity of states and local communities to bear. Every proposal to date would adversely impact the federal, state, and local partnership for Medicaid. Medicaid is a key tool in the battle against the opioid epidemic and is the largest single funder of mental health services and substance abuse treatment. Counties in 26 states help fund Medicaid and many help to administer the program. For these reasons, NACo is currently engaged in the health reform debate on Capitol Hill. Whether or not the Senate passes a bill, NACo continues to focus on the real life impact on counties and their residents and the potential federal cost shifting to local government.

Supervisors Ridley-Thomas and Barger interviewed live on the importance of lifting up the issue of homelessness in the media and Affordable Care Act reform.

“This is a non-partisan issue that impacts all counties,” said Supervisor Kathryn Barger. “This is a crisis and people’s lives are being played as a political pawn.”

Counties continue to invest $80 billion annually in community health — $1 in every $5 of county budgets. Counties support nearly 1,000 hospitals and 900 long term care facilities through these resources. They provide behavioral health services through 750 behavioral health authorities and community providers. About 75% of the United States population is served by county-based behavioral health systems. The debate being advanced about repealing the Affordable Care Act puts these services at risk. NACo further noted that Counties support comprehensive tax reform that lowers the rates for taxpayers and spurs economic growth. But NACo added this was not about tax reform, but about health outcomes for the most vulnerable among us.

“The County of Los Angeles would be the most adversely impacted county in the nation,” said Chairman Ridley-Thomas.

Also on the minds of county delegates are ways to combat homelessness and enhance local economic development. Biotech, one of the biggest boom industries of this century has found its way to Columbus, Ohio — now one of the leading cities in the nation for the growing industry. Chairman Ridley-Thomas toured Rev 1 Ventures, a 64,000 square foot business incubator that co-locates 25 tech and pharmaceutical startups, with a quarter of them being bioscience and biotech companies with the hope of inspiring similar ventures in Los Angeles County much like LA BioMed on the Harbor UCLA Campus.